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NPI Code Detail

MEDICARE: MR. MATTHEW G BAKER PA-C

MEDICARE: MR. MATTHEW G BAKER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant0010-03915NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00108973OTHERILRR MEDICARE PROV #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1IL0111OTHERILJOHN DEERE PROV #
3713460OTHERILHEALTHLINK PROV #
4092552OTHERILHEALTH ALLIANCE PROV #
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356349914
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW G BAKER PA-C
Provider Business Mailing Address
First Line : 101 E WT HARRIS BLVD
Second Line : SUITE 5202
City : CHARLOTTE
State : NC
Zip : 28262-3485
Country : US
Telephone Number : 704-547-1495
Fax Number : 704-547-1861
Provider Business Practice Location Address
First Line : 101 E WT HARRIS BLVD
Second Line : SUITE 5202
City : CHARLOTTE
State : NC
Zip : 28262-3485
Country : US
Telephone Number : 704-547-1495
Fax Number : 704-547-1861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 06/17/2016

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